Paraganglioma affecting the cauda equina region is very rare and can be misinterpreted as an ependymoma which is more common at this site. A 38-year-old woman with a paraganglioma in the cauda equina is presented. MRI revealed a well-circumscribed, intradural, extramedullary tumor nodule with the dimensions of 2.5x1x1 cm. The patient underwent L3 laminectomy and total excision of the tumor. The tumor was diagnosed as ependymoma and the patient was decided to undergo adjuvant radiotherapy. The patient applied to our medical center for a second opinion. Histopathologically, her tumor was found to be a paraganglioma with ependymal features. Therefore no adjuvant therapy was applied. There is no evidence of recurrence or metastases for 15 months after her operation. Paraganglioma in the cauda equina/ filum terminale is very rare and can be misdiagnosed as ependymoma especially when it exhibits ependymoma-like histology. This rare form of paraganglioma behaves like a WHO grade I tumor of CNS like classic paraganglioma. No recurrence or metastasis is expected when it is totally resected. Morphology can be misleading hence immunohistochemistry and/or ultrastructural study is necessary for correct diagnosis.KeywoRds: Paraganglioma, Ependymoma-like histology, Filum terminale, Immunohistochemistry, CD 99 ÖZKauda ekuina yerleşimli paraganglioma oldukça nadir olup, bu lokalizasyonda daha sık görülen ependimoma ile karışabilir. Bu çalışmada kauda ekuina yerleşimli, ependimoma benzeri histoloji gösteren paraganglioma olgusunu sunmayı amaçladık. 38 yaşındaki bayan hastaya, MR yöntemi ile saptanan 2,5x1x1 cm boyutlarda, intradural-ekstramedüller yerleşimli, iyi sınırlı kitle nedeniyle bir başka merkezde L3 laminektomi ve kitle eksizyonu uygulanmıştır. Burada tümor, ependimoma olarak rapor edilmiştir ve hastaya adjuvan radyoterapi verilmesi kararı alınmıştır. Hasta, tanı ve tedavisi konusunda ikinci bir görüş almak üzere merkezimize başvurmuştur. Merkezimizde yapılan patolojik inceleme ve immünohistokimyasal boyamalar sonucu, tümörün ependimoma benzeri histoloji gösteren paraganglioma olduğu rapor edilmiştir. Bunun üzerine hastanın ek tedavi almamasına karar verilmiştir. Hastanın, ameliyatından sonraki 15 aylık izlemi sonucunda nüks ya da metastaz bulgusu izlenmemektedir. Kauda ekuina/filum terminale yerleşimli paraganglioma oldukça nadir olup özellikle ependimoma-benzeri histoloji gösteren olan olgular, ependimoma ile karışabilmektedir. Bu tür olgularda klinik seyir, SSS tümörleri-WHO Sınıflamasında yeralan derece I tümörlerdeki gibi olup, tedavide kitlenin total eksizyonunun yapılması yeterlidir. Morfolojik bulgular yanıltıcı olabileceği için immünohistokimyasal ve/veya ultrastrüktürel yöntemler, kesin tanı için gereklidir.
Objective: Superficial tumors including Ta, Tis, and T1 make up 75% of urothelial carcinomas of the bladder. While the behavior of these superficial urothelial cancers is relatively benign, invasive tumors have a significant mortality rate. However, Ta and T1 tumors might display different biological behavior. There is therefore a great need for biomarkers that can accurately distinguish the behavior of urothelial carcinomas in addition to tumor grade and stage. our aim was to determine the immunohistochemical expression profile of insulin like growth factor ii mrna binding Protein 3 (iMP3) and its correlation with tumor stage and grade in benign urothelium and bladder urothelial carcinomas. Material and Method: The expression of iMP3 in 91 patients with benign urothelium (20 cases), low grade invasive (17 cases) / non-invasive (20 cases) urothelial carcinoma and high grade invasive (20 cases) / non-invasive (14 cases) urothelial carcinoma was evaluated by immunohistochemistry in this study. Results: iMP3 was not expressed in benign urothelium, low-grade non-invasive urothelial carcinoma and high grade non-invasive urothelial carcinoma. Expression of iMP3 was found in 11.76% of low-grade invasive urothelial carcinomas and 55% of high grade invasive urothelial carcinomas. Statistical analysis including χ2 tests showed that iMP3 expression of invasive urothelial carcinomas was statistically significant (p<0.000). Conclusion: The detection of iMP3 only in invasive carcinomas although some of them were low grade showed that the expression of iMP3 may be related to aggressive behavior of urothelial carcinomas. ÖZ Amaç: Ürotelyal karsinomların %75'i yüzeyel tümörler olarak Ta, Tis ve T1 şeklinde karşımıza çıkmaktadır. Yüzeyel tümörler benign davranış gösterirken, invaziv tümörlerde ise yüksek mortalite oranı bildirilmiştir. Bununla birlikte, Ta ve T1 tümörler, farklı biyolojik davranışlar sergileyebilmektedirler. Bu durum, ürotelyal karsinomların davranışının belirlenmesinde, histopatolojik evre ve dereceye ek olarak, bazı biyolojik belirteçlere ihtiyaç olduğunu göstermektedir. Bu çalışmada amacımız, benign ürotelyum ile mesanenin ürotelyal karsinomlarında insulin like growth factor ii mrna binding Protein 3 (iMP3) ekspresyon profilini belirleyerek, tümörün histopatolojik evresi ve derecesi ile ilişkisini saptamaktır. Gereç ve Yöntem: Bu çalışmada 91 hastaya ait benign ürotelyum (20 olgu), düşük dereceli invaziv (17 olgu) / non-invaziv (20 olgu) ürotelyal karsinom ve yüksek dereceli invaziv (20 olgu) / non-invaziv (14 olgu) ürotelyal karsinom tanısı almış olgular immünohistokimyasal olarak iMP3 ekspresyonu açısından değerlendirildi. Bulgular: Benign ürotelyum, düşük dereceli non-invaziv ürotelyal karsinom ve yüksek dereceli non-invaziv ürotelyal karsinom tanısı almış olgularda iMP3 ekspresyonu saptanmadı. Düşük dereceli invaziv ürotelyal karsinom olgularının %11,76'sında, yüksek dereceli invaziv ürotelyal karsinom olgularının %55'inde iMP3 ekspresyonu saptandı. χ2 testi ile yapılan istatistiksel analizde, invaziv tümö...
Objective: Superficial tumors including Ta, Tis, and T1 make up 75% of urothelial carcinomas of the bladder. While the behavior of these superficial urothelial cancers is relatively benign, invasive tumors have a significant mortality rate. However, Ta and T1 tumors might display different biological behavior. There is therefore a great need for biomarkers that can accurately distinguish the behavior of urothelial carcinomas in addition to tumor grade and stage. our aim was to determine the immunohistochemical expression profile of insulin like growth factor ii mrna binding Protein 3 (iMP3) and its correlation with tumor stage and grade in benign urothelium and bladder urothelial carcinomas. Material and Method: The expression of iMP3 in 91 patients with benign urothelium (20 cases), low grade invasive (17 cases) / noninvasive (20 cases) urothelial carcinoma and high grade invasive (20 cases) / non-invasive (14 cases) urothelial carcinoma was evaluated by immunohistochemistry in this study. Results: iMP3 was not expressed in benign urothelium, low-grade non-invasive urothelial carcinoma and high grade non-invasive urothelial carcinoma. Expression of iMP3 was found in 11.76% of low-grade invasive urothelial carcinomas and 55% of high grade invasive urothelial carcinomas. Statistical analysis including χ2 tests showed that iMP3 expression of invasive urothelial carcinomas was statistically significant (p<0.000). Conclusion: The detection of iMP3 only in invasive carcinomas although some of them were low grade showed that the expression of iMP3 may be related to aggressive behavior of urothelial carcinomas.
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